Ensemble Health Partners is seeking a detail-oriented Coder Quality Auditor to ensure coding accuracy and compliance across inpatient and outpatient accounts. As a Coder Quality Auditor, you will conduct audits, provide education and guidance to coding staff, and serve as a subject matter expert for professional fee coding. You will review documentation, assess adherence to CMS and AMA guidelines, and help improve coding quality and consistency. This role is ideal for experienced coders who are passionate about quality assurance, mentoring, and contributing to a high-performing revenue cycle management team.
Why Join Ensemble Health Partners as a Coder Quality Auditor
At Ensemble Health Partners, the Coder Quality Auditor plays a critical role in maintaining coding excellence and ensuring accurate reimbursements for hospitals and physician groups. You’ll enjoy remote work flexibility, comprehensive benefits, bonus incentives, tuition reimbursement, and opportunities for professional development and career advancement.
Key Responsibilities of a Coder Quality Auditor
Quality Review
-
Audit inpatient and outpatient accounts monthly and quarterly to assess coder accuracy and compliance.
-
Perform baseline and follow-up reviews to evaluate comprehension of training and education initiatives.
-
Assist with special project audits as assigned.
Education and Training
-
Evaluate educational needs of coding staff based on audit trends and results.
-
Develop presentations, learning materials, and coding handbooks.
-
Train new and existing coders, identifying opportunities for cross-training and workflow improvements.
Coding Support
-
Assist operational coding teams with coding, edits, denials, and appeals as needed.
-
Serve as a technical resource, ensuring coding practices meet AMA, CMS, and professional standards.
Reporting and Compliance
-
Provide audit findings to coding management, individual coders, and leadership.
-
Create reports and documentation as requested, immediately reporting any compliance risks.
-
Maintain up-to-date knowledge of coding principles for specialties including Cardiology, Electrophysiology, and Cardiothoracic/Vascular.
Experience and Expertise
-
Minimum 5+ years of coding experience.
-
At least 3+ years of auditing experience.
-
Proficient in multiple EMRs, encoders, and Microsoft Office Suite.
-
Strong understanding of HIPAA regulations and ability to maintain confidentiality.
-
Excellent written and verbal communication skills.
-
Knowledge of medical/surgical terminology.
Education and Certifications
-
Associate’s degree or equivalent experience.
-
Required certifications (must maintain current):
-
CPC (Certified Professional Coder)
-
CCS-P (Certified Coding Specialist – Phys Based)
-
CCS (Certified Coding Specialist)
-
CPMA (Certified Professional Medical Auditor)
-
RHIA (Registered Health Information Administrator)
-
RHIT (Registered Health Information Technician)
-
-
Preference for specialty certifications: CCC (Cardiology) or CCVTC (Cardiovascular/Thoracic Surgery).
Benefits and Recognition
-
Bonus incentives, paid certifications, and tuition reimbursement.
-
Comprehensive benefits supporting physical, emotional, and financial well-being.
-
Professional growth opportunities and career advancement.
-
Quarterly and annual recognition programs for outstanding performance.
-
Remote work flexibility and collaborative, innovative culture.
About Ensemble Health Partners
Ensemble Health Partners provides technology-enabled revenue cycle management solutions for hospitals and physician groups nationwide. Recognized for multiple awards, including “Best in KLAS” and top workplace honors, Ensemble is committed to innovation, employee growth, and improving healthcare outcomes for the communities we serve.